Program for Resistance, Immunology, Surveillance & Modeling of Malaria in Uganda (PRISM) Renewal

Summary/Abstract Malaria remains one of the most important global health challenges, with an estimated 247 million cases and 619,000 deaths in 2021, of which 95% of cases and 96% of deaths were in the WHO Africa region. The scale up of proven control interventions resulted in significant reductions in the burden of malaria following the turn of the century. However, since 2015 progress has stalled and even reversed course in some of the highest burden countries of Africa. Indeed, a myriad of challenges, including the spread of insecticide resistance, changes in vector composition and behavior, the emergence of artemisinin partial resistance, and the COVID- 19 pandemic have created a precarious situation. Our program called “PRISM” has been based in Uganda, representing the East African region for the International Centers of Excellence for Malaria Research network. Uganda is emblematic of the challenges faced by high burden countries, where routine surveillance systems are inadequate to assess trends in the burden of malaria or to monitor the impact of control interventions. Through PRISM we have implemented a comprehensive malaria surveillance program including enhanced health facility-based surveillance and detailed longitudinal studies. Complementary laboratory-based studies include surveillance for markers of antimalarial drug and insecticide resistance and serologic measures of malaria exposure. These studies have greatly improved our understanding of the epidemiology of malaria in Uganda and of the impact of control interventions. In this renewal application we propose to continue key components of our health facility and community-based malaria surveillance to strategically focus on quantifying the impact of malaria control interventions, working in close collaboration with our partners at the Uganda National Malaria Control Division (NMCD). We will utilize specimens collected from our surveillance system to generate genomic and serologic data to address key questions about malaria epidemiology, transmission, diagnostics, and antimalarial drug and insecticide resistance. The central theme of our program will be to improve malaria surveillance to better assess the impact of malaria control interventions and guide evidence-based utilization of existing and novel interventions to reduce the malaria burden using an adaptive approach. The program will consist of three research projects linked together in an integrated manner to maximize scientific discovery. Research Project 1 (Surveillance and Impact Evaluation Project) will utilize health facility and community-based malaria surveillance data from sites with varied transmission intensity and control interventions to monitor trends, estimate the impact of interventions, and provide clinical data and specimens for our other research projects. Research Project 2 (Resistance Project) we will characterize the evolution of genotypic markers of drug and insecticide resistance and assess the impacts of resistance on malaria transmission. Research Project 3 (Molecular Epidemiology Project) will characterize key parasite and vector genomic traits and human serological responses. Project Number: 3U19AI089674-16S1 | Fiscal Year: 2025 | NIH Institute/Center: National Institute of Allergy and Infectious Diseases (NIAID) | Principal Investigator: MATTHEW DORSEY (+1 co-PI) | Institution: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, SAN FRANCISCO, CA | Award Amount: $590,328 | Activity Code: U19 | Study Section: ZAI1-CAB-M(J1) View on NIH RePORTER: https://reporter.nih.gov/project-details/3U19AI08967416S1